Methods to insert catheters in left atrium and/or ventricles through surgery such as an outer cut on the chest wall are well known and known to be a very sensitive and high-risk approach from a patient's point of view, and requires close post surgical control, or in the venous system of the heart, which method is often impossible to carry out and requires considerable expertise in performance, thus limiting general application. Currently, there exists a technique, which includes intracavity stimulation of the left ventricle. However, it is complex and difficult to perform.
The insertion of catheters in right atrium and/or ventricles is currently performed in a simple way by inserting the catheter in the subclavian, cephalic or jugular vein after a simple puncture and by means of a catheter introducer. However, this is not the case when the catheter is to be inserted in the left atrium and ventricle, because there is no direct path through the mentioned veins. Typically, surgery is required in order to insert the catheter outside (the epicardial region) the atrium and/or the left ventricle, including a cut in the external chest wall. Such a procedure entails a great risk. On the other hand, this technique offers a very restricted access to the left atrium and ventricle, thus preventing the choice of a preferred implantation site.
There is an option of inserting the catheter in the venous system of the heart, which is often impossible to perform due to the morphologic structure of the system. Such option requires considerable expertise in technique and is limiting in its general application.
Another technique uses the transseptal puncture of the atrium to insert the catheter by the antegrade venous route. This technique requires multiple passing of sheaths, balloon catheters and lines through the interatrial septum, successive dilations of the interatrial septum, and typically more, which turn it complex and increases risk to the patient.